Unveiling the Fungal Frontier: Characterizing Diversity and Antifungal Resistance in Immunocompromised ICU Patients With Respiratory Tract Infections
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 250
- 试验地点
- 1
- 主要终点
- Number of fungal species causing pneumonia in immunocompromised ICU patients
研究概览
简要总结
Immunocompromised individuals face a heightened risk of life-threatening fungal infections, which arise from a multitude of environmental and commensal fungi. Surveillance data from ICUs worldwide identifies Candida spp. as the dominant foe, responsible for 80% of such infections, earning it the dubious distinction of being the third most prevalent pathogen. While C. albicans holds the dubious crown as the most common Candida offender, recent years have witnessed a concerning trend toward non-Albicans candida, raising concerns about potential antifungal resistance.
详细描述
For critically ill patients in the ICU, the threat of invasive fungal infections is a hidden danger, particularly in the presence of any of the following opportunistic factors:
(A) Pre-existing lung disease: Idiopathic pulmonary fibrosis (IPF) , Chronic obstructive pulmonary disease (COPD), or Sarcoidosis.
(B) Patient comorbidities:
- Immunosuppression: Neutropenia, Corticosteroid therapy, Immunosuppressive medication for inflammatory or autoimmune diseases; T-cell suppressants: Antithymocyte globulin (ATG), Calcineurin inhibitors (e.g., tacrolimus, cyclosporine) or B-cell suppressants: Rituximab, Severe sepsis (immune paralysis): Inherited severe immunodeficiency: Chronic granulomatous disease (CGD), Wiskott-Aldrich syndrome (WAS), and Common variable immunodeficiency (CVID) or Acquired immunodeficiency due to HIV/AIDS.
- Underlying medical conditions: Liver failure, Diabetes mellitus, or cardiovascular disease.
- Viral Pneumonia: Influenza-associated pulmonary aspergillosis (IAPA) and Coronavirus disease 2019 (COVID-19)
- Hematological and solid malignancies.
- Hematopoietic stem cell transplantation (HSCT).
- Prior fungal exposure: Aspergillus colonization before or during ICU admission .
(C) Environmental factors: Construction work, Geo-climatic factors, Tobacco or cannabis use, Air, food, or spice contamination, Gardening activity or occupation.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Diagnostic
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •All adult patients (aged >18 years old) admitted to the Assiut University Hospital's intensive care units with pneumonia and hospitalized patients who developed hospital-acquired or ventilator-associated pneumonia who don't respond to antibiotics for 48 hours or with a CT finding suspected for fungal pneumonia.
- •Patients included must have at least one of the following conditions as a contributor to immunocompromise:
- •Pre-existing lung disease: IPF, COPD, or sarcoidosis.
- •Immunosuppression: Neutropenia, on corticosteroids, or immunosuppressive drugs, inherited or acquired immunodeficiency.
- •Underlying comorbidities: (Diabetes Mellitus,Chronic kidney disease, Liver cirrhosis)
- •Malignancy (Hematological or solid)
排除标准
- •Patients refused to contribute to the study.
- •Unsatisfactory sample.
研究组 & 干预措施
Immunocompromised ICU patients
Immunocompromised ICU Patients with Respiratory tract infections
干预措施: Complete blood count (Diagnostic Test)
Immunocompromised ICU patients
Immunocompromised ICU Patients with Respiratory tract infections
干预措施: C-reactive protein, urea, creatinine, Random blood glucose (RBG), aspartate aminotransferase (AST), alanine aminotransferase (ALT) (Diagnostic Test)
Immunocompromised ICU patients
Immunocompromised ICU Patients with Respiratory tract infections
干预措施: CT chest (Radiation)
Immunocompromised ICU patients
Immunocompromised ICU Patients with Respiratory tract infections
干预措施: Microscopic examination (Diagnostic Test)
Immunocompromised ICU patients
Immunocompromised ICU Patients with Respiratory tract infections
干预措施: culture and sensitivity (Diagnostic Test)
结局指标
主要结局
Number of fungal species causing pneumonia in immunocompromised ICU patients
时间窗: baseline
次要结局
- Determine the antifungal susceptibility profiles of the identified fungal isolates.(baseline)
- Number of associated specific patient factors with the type or antifungal resistance of fungal infections(baseline)
研究者
Asmaa Nady Hussein
Lecturer of Internal Medicine
New Valley University